Individual provider Active NPI

Jennifer Anne Lombardo, PH.D

  • Clinical Psychologist
  • Midland, MI
National Provider Identifier
1871693481
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301013371 Issued in MI
Practice address
104 W Wackerly St
Midland, MI 48640-2791
Phone
(989) 486-3021
Fax
(989) 486-1843
NPI assigned
Sep 24, 2006
Last updated
Oct 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301013371 MI Primary

Addresses

Primary practice location

104 W Wackerly St
Midland, MI 48640-2791

Mailing address

104 W Wackerly St
Midland, MI 48640-2791
Phone (989) 486-3021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070215000226 MI Practitioner - Clinical Psychologist 0345242673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

104 W Wackerly St
Midland, MI 48640-2791
Phone (989) 486-3021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Perspectives Psychological Associates of Midmichigan LLC Clinical CurrentSince Mar 13, 2018 Accepting new patients

Locations

104 W Wackerly St
Midland, MI 48640
Phone (989) 486-3021

201 S University Ave
Mt Pleasant, MI 48858
Phone (989) 572-0246

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1871693481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402791",
            "telephone_number": "989-486-3021",
            "fax_number": "989-486-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402791",
            "telephone_number": "989-486-3021",
            "fax_number": "989-486-1843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMBARDO",
        "first_name": "JENNIFER",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-24",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301013371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

Verify at the official NPI Registry.